Emergency care

We operate on the day for emergency dentist appointments, and although you may have to wait a short while, we guarantee to see you that day. In the first instance, please contact us by telephone 020 77311162, email or arrange a free video consultation.

Dental emergencies can present in many forms and typically cause acute or chronic pain, difficulty in eating and chewing, loss of function, cosmetic issues, orthodontic breakages to loss of retainers or dentures for example. The most common type of dental emergency include:

Toothache is arguably the most common form of dental emergency appointment we encounter. The symptoms can vary from mild temperature sensitivity, extreme hot and cold sensitivity, pain on biting, pressure pain, intermittent sharp localised pain, low grade dull ache, constant deep generalised aching to severe unbearable toothache which is not affected by over the counter pain relief.

Determining the cause of the toothache is of course the key to treatment. There are many factors to take into consideration but the usual causes are tooth decay, leaking fillings, open margins on crown and bridgework, trauma, cracked tooth syndrome, gum disease, wisdom tooth infection, peri implantitis around dental implants, failed root canal treatments, excessive tooth grinding at night or bruxism, abscess formation, ulceration, cyst formation, infection around retained roots and trigeminal neuralgia to name a few.

Once the cause is identifed, we will be able to provide the correct diagnosis and implement treatment to allevaite the toothache.

Another very common emergency dental problem is a chipped or broken tooth. This may be the edge of a front tooth or the cusp of a premolar or molar back tooth. Often the areas are sharp on the tongue and irritating. If the chip is minor, the treatment is a straight forward repair usually with composite resin (white filling). It is important to repair chipped teeth as leaving the underlying tooth exposed can lead to infiltration of bacteria and greater problems further down the line.

The main reason for a crown coming off or being lost is due to an underlying problem with the tooth or 'core'. This could be decay, a crack or the cement failing. A post crown is where the tooth has a root canal treatment and a metal or fibre post has been placed into one of the roots for anchorage. If the post loosens, this is another cause for the crown to come off or feel loose. It is important to keep the crown clean and safe until you can visit us. If the underyling tooth is sound, we can often re cement the crown. If the crown no longer fits or the underlhyying tooth needs remedial treatment, we will need to replace the crown.

Losing a porcelain veneer may not be a severe dental emergecny but it is certainly a cosmetic issue especially as most veneers tend to be placed on the front teeth. The most common reason for a veneer coming off is an issue with the underlying bonding. As with crowns, keep the veneer in a safe place and bring it with you to the appointment. As long as the underyling tooth and veneer are sound, we can usually re bond with a good success rate. However, if the veneer is chipped or damaged, a replacement will be required.

A dental trauma can occur from situations such as contact sports, an assault, a fall or biting with excessive force inadvertently. In the worst scenario, the entire tooth is knocked out or 'avulsed'. This is a serious situation and time is of the essence. If you can see us within one hour of the trauma, it is possible to save the tooth by re positioning and splinting. Please clean the tooth gently and keep it in some milk if possible. Do not scrub the tooth or exert any force on the roots. If it is impossible to see us in Fulham within the hour period and you can re insert the tooth in the correct position without forcing it in, you should do so. Needless to say, you will need to see someone on the same day. In most cases, the tooth will require a root canal treatment. However, there is a large risk that the tooth will be lost and this should be planned for.

Other cases of trauma include luxation injuries and occlusal trauma. Luxation injuries can be intrusion, lateral or extrusion. In most cases, we will aim to re position the tooth and spint it to adjacent teeth for support. This may be for a number of weeks or months depending on recovery. Once again, it is likely that root canal treatment is required especially for an adult tooth but this will be monitored over time. Occlusal trauma is generally where there has been a direct force down the centre of the tooth which bruises the ligament. This is quite painful for a while and we will advise a soft diet for a week or so. The recovery rates are better than for luxation injuries.

Some bleeding after a tooth extraction is normal. This often appears worse due to saliva. However excessive bleeding for a over 24 hours is an issue and must be seen to. In the first instance, bite down with firm pressure for 10-20 minutes on sterile gauze and repeat as necessary. If after a few attempts, the bleeding does not stop, please contact us. The socket usually needs to be dressed and some sutures may be required.

A dry socket is an extremely pain condition that can occur after a particularly difficult extraction or in smokers. Dry socket is when the blood clot at the site of the tooth extraction fails to form or it dislodges before the wound has healed leaving the underlying bone and nerves exposed. The pain can radiate to the side of the face and over the counter medications are ineffective. The pain usually intensifies after 3-5 days and a bad taste and smell may be present.

We will need to see you to clean and dress the area and possibly provide antibiotics. Dry socket will not heal without emergency dental treatment.

Wisdom tooth pain is usually pericoronitis which is the inflammation of the tissue overlying the wisdom tooth. This can be extremely pain resulting in tenderness, bleeding of the area, limited opening, jaw pain and swelling. The normal cause is due to impaction of wisdom teeth due to lack of space in the mouth. Often the wisdom tooth is either horizontally impacted ( on it's side) or vertically impacted (upright but cannot fully erupt)

Rinsing with hot salt water or Corsodyl will help as with gentle brushing using a soft tooth brush. We advise the super soft ones from Curaprox. If the area becomes infected and swollen, anti biotics will be required. If there are recurrent episodes of pericoronitis, then we may may to consider removing the wisdom tooth/ teeth.

These are just some of the examples of dental emergencies we treat at our dental practice in Fulham. Should you need treatment, please contact us as soon as possible or arrange a free video consultation.